Thursday, September 8, 2016

Hiccup is sudden, unintentional contraction of the diaphragm
muscle. The diaphragm lies at the base of the lungs and is essential for normal
respiration. Phrenic and vagus nerves that control the diaphragm play an
important role in its function.

Excessive eating
and drinking, as well as consumption of carbonated beverages may irritate the
diaphragm and cause hiccups. Also sudden temperature change (i.e. hot – cold
showers and hot – cold drinks) and emotional stress have been found to play a
role on its onset. Hiccups can also be psychogenic or idiopathic. Some drugs
(benzodiazepines, barbiturates, alpha methyldopa, etc.) may cause hiccup.

In this article, there
is a selection of questions and answers concerning fatigue and weakness. These
questions were asked and answered in interviews I have given to Greek
newspapers (ΒΗΜΑ, ΠΑΡΟΝ, ΚΑΘΗΜΕΡΙΝΗ etc) and TV stations (ALPHA, ATHENS TV,
ΚΑΝΑΛΙ 10, SKY, ALTER etc).

1. What is chronic
fatigue syndrome?

This syndrome consists
of severe fatigue symptoms lasting more than six months. This fatigue affects
both physical and mental functioning.

2. How is chronic
fatigue distinguished from common weakness?

Chronic fatigue is
persistent or relapsing whereas common weakness lasts for less than a week.
Simple measures, such as sleep and healthy diet, are often sufficient, in case
of common weakness.

3. What causes chronic
fatigue?

The chronic fatigue
syndrome could be associated with the following:

• Alcohol abuse

• Insomnia

• Drugs such as
benzodiazepines

• Over-fatigue

• Menopause

• Malnutrition

• Anemia

• Hypotension

• B12 deficiency

• Infectious diseases

• Biochemical
disturbances

• Cardiovascular
diseases

• Endocrine disorders

• Thyroid disease

• Autoimmune disorders

• Sleep apnea

• Depression

• Psychosis

• Anorexia nervosa

This type is called secondary
chronic fatigue syndrome.

For idiopathic
syndromes, no specific cause can be found.

If four or more of the
following criteria are present for more than six months, the syndrome is called
idiopathic chronic fatigue syndrome:

• Impaired memory or
concentration unrelated to drugs or alcohol use

• Unexplained muscle
pain

• Polyarthralgia

• Sleep disturbances

• Post exertional
malaise lasting over 24 hours

• Sore throat not
caused by infection

• Tender cervical or
axillary nodes.

If these criteria are
not fully met, then the disease is called idiopathic chronic fatigue.
Idiopathic syndromes come with a variety of implications such as immunologic
disturbances, neurologic disturbances, abnormal gene expression and psychological
disturbances.

4. What is the
treatment?

Patients with
secondary chronic fatigue syndrome have a secondary correctable or specifically
treatable cause. Special treatment is the cornerstone of therapy.

In case of idiopathic
syndromes, treatment includes exercise programmes, cognitive therapy and
special drugs.